Provider Demographics
NPI:1417095472
Name:CENTER FOR COMMUNITY RESOURCES, INC.
Entity Type:Organization
Organization Name:CENTER FOR COMMUNITY RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROBB
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:724-431-0095
Mailing Address - Street 1:127 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-5935
Mailing Address - Country:US
Mailing Address - Phone:724-431-0095
Mailing Address - Fax:724-431-0099
Practice Address - Street 1:212 - 214 SOUTH MAIN STREET
Practice Address - Street 2:SUITE 625
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5987
Practice Address - Country:US
Practice Address - Phone:724-431-0095
Practice Address - Fax:724-431-0099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251K00000X, 261Q00000X
PA442680251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007491000013Medicaid
PA1007491000033Medicaid
PA497401OtherVALUE BEHAVIORAL HEALTH
PA1007491000032Medicaid
PA1007491000034Medicaid
PA1007491000052Medicaid
PA1007491000028Medicaid